A recent front-page story in The New York Times, detailed the dilemma for hourly workers without banking credentials who are employed at companies with payroll systems that require automatic deposit to checking or savings accounts. In many instances, the only alternative for these workers is payment via a prepaid debit card. While compensation via a prepaid card system costs less to administer for the company, there are some hidden, and not so hidden, charges for the hourly worker. Dreaded card fees – use fees, non-use fees, lost or stolen card fees, transfer card fees, and the like – deplete the worker’s revenue to the point that many in the minimum wage pool actually make significantly less than the law-required amount. In essence, the company saves at a real cost to the employee.
As I read this article, I couldn’t help but think about the way BBK has orchestrated its clinical trial patient reimbursement program where none of the costs of a debit card are born by the patient. In direct contrast with other such options, BBK has ensured that when a sponsor reimburses a patient for travel expenses, the amount on the card represents the full reimbursement and cannot be garnished in any way.
In successfully designing our Ready. Set. Go.SM (RSG) Global Reimbursement Card program to be as patient and staff friendly as possible, there were many hurdles to overcome, not the smallest of which was uncovering the quirky nuances which ultimately dictate the reimbursement landscape for a trial. For instance, depending upon who you are – sponsor, provider, and yes, even the tax man – in conjunction with the label you apply to a person who participates in a clinical trial – subject, volunteer, worker, patient – there is a corresponding effect on the net amount of money the participant receives for the travel and related expenses that are incurred during a study protocol period.
To be specific, if you are viewed as a “subject,” as in years past, the notion of reimbursing a “data point” was never at issue. In direct contrast, if you are a volunteer helping to advance medical science, you are deemed worthy of reimbursement for your travel expenses as it should not cost you for your benevolence. However, if you are viewed as a patient traveling to a regularly scheduled doctor appointment, why should the site pay for your lunch?
There are many trials, particularly those which target patients with rare diseases, when travel reimbursement including airfare and hotel easily exceed the non-taxable criteria. This is a particularly hypocritical notion to me as, in this scenario, you are using your post-tax dollars to pay for your travel fare to your voluntary commitment and then, the government requires that your reimbursement be taxed as if you were receiving monetary compensation for employment.
Back to debit cards. When you fold on top of this complex reimbursement schema, a card system that depletes the receiver and not the giver, the picture becomes exponentially exacerbated. So, in the words of BBK’s product development team, it seems prudent to take the stance of “ready, set, go – and pay already.”